Key result
Aortic vascular graft directly entraps jejunum, causing rare closed-loop bowel obstruction three years post-surgery.
Why the study?
Closed-loop bowel obstruction caused by entrapment by an intra-abdominal synthetic vascular graft is exceptionally rare and should be considered in patients with bowel obstruction.
Case Report (n=1)
No
Closed-loop bowel obstruction caused by entrapment by a synthetic vascular graft is exceptionally rare but should be considered in patients with an intra-abdominal synthetic vascular graft presenting with bowel obstruction.
May signal rare closed-loop bowel obstruction from prior aortobiiliac graft after cardiac surgery; leaves open prospective studies on prevention.
A 68-year-old male has a significant past medical history of severe aortic stenosis, peripheral arterial disease, chronic kidney disease, and an abdominal aortic aneurysm treated with a bifurcated interposition aortobiiliac graft. He was admitted to the hospital for an elective one-vessel coronary artery bypass graft and placement of a bioprosthetic aortic valve. Postoperatively, he developed worsening abdominal pain, leukocytosis, and inability to tolerate nutrition by mouth. Computed tomography revealed moderately dilated loops of the small bowel with two transition points in the right lower quadrant. He was taken emergently to the operating room for an exploratory laparotomy, and a 28-cm necrotic jejunal loop was entrapped posterior to the right iliac segment of the graft. In a patient with an intra-abdominal synthetic vascular graft, a closed-loop bowel obstruction caused by entrapment by the vascular graft is exceptionally rare; however, it should be considered in the presence of bowel obstruction.
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Mann et al. (2021) conducted a case report in Closed-loop bowel obstruction (n=1). Aortobiiliac Dacron graft was evaluated. A synthetic vascular graft from an open abdominal aortic aneurysm repair caused a rare closed-loop bowel obstruction by direct entrapment of the jejunum three years postoperatively.
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